- CVS Health (Annapolis, MD)
- …can live in any state. There is no travel expected with this position. As a Utilization Management Nurse Consultant , you will utilize clinical skills to ... to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee… more
- The Arora Group (Annapolis, MD)
- …algorithms, CM software, databases for community resources, etc. + Integrate CM and utilization management (UM) and integrate nursing case management with ... Registered Nurse Case Manager Nurse Currently recruiting...meet the health care needs, including medical and/or psychosocial management , of specified patients + Serve as consultant… more
- CareFirst (Owings Mills, MD)
- …Compact State Licensure + CCM - Certified Case Manager + LNCC - Legal Nurse Consultant Certified **Experience** : 2 years medical-surgical or similar clinical ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis, and evaluation of...**Preferred Qualifications:** + 2 years experience in Medical Review, Utilization Management or Case Management … more
- CareFirst (Baltimore, MD)
- …**Knowledge, Skills and Abilities (KSAs)** + Knowledge of NCQA requirements of utilization review, Case Management standards and guidelines, appeal rights and ... multiple strategic clinical projects that span organizational boundaries, responsible for management of corporate care cost directives and goals. + Oversees the… more
- Wellpath (Bel Air, MD)
- …the organization's Code of Conduct. + Demonstrates knowledge of risk management , clinical precautions, infection control, fall prevention, utilization of ... improvement activities,providesdirect supervision, and serves as a resource and consultant to nursing staff. + Monitorssafety issues,evaluateservicedeliveryand staff growth,… more